FOR PATIEnts

If, after looking through my website, you have questions and/or are interested in making your first appointment, please call our main number (702)-508-9461 between the hours of 9:00 AM and 4:30 PM and select extension 3. We do our best to return phone calls and messages as quickly as we are able. If you do not hear back from myself or an associate within three days please feel free to call and leave another message.

To make your first visit as comfortable and stress-free as possible, I would like to walk you through what to expect when you come to see me for the first time. But please, do not fill out any forms until your appointment is set.

If you need to cancel an appointment, please do so at least 24 hours before your appointment.

Plan to arrive early for your first appointment. I want you to have your full time for our session. Read the directions to our office on our Contact page.

Come into the waiting room and please turn the switch to the ON position for my office to let me know you have arrived, and then have a seat in our waiting room. There are books pertaining to mental health available on our bookshelves for you to read while you wait.

Payment will be due at the time of evaluation. We accept cash, checks or credit card (VISA/ Mastercard/American Express) only. 

Practice Guidelines and Consent to Treatment Forms are available on my Resources page. Notice of Privacy Practices are also available for download and review. 

Once you have booked an appointment, please print and fill out the intake forms. Please bring the forms with you to your first appointment.

Our resources page has screening tools for several other disorders and you can print and fill out any of them that you feel apply to you and bring to your appointment. Answers to some commonly asked questions about starting treatment are available on our FAQ page. For any further questions or queries, please give us a call.

We look forward to working with you.

Psychiatric Intake Form (for adults)

Child-Adolescent Psychiatric Intake Form (to be filled out by parents)

Consent to Treatment / Release of Information Form

Cancellation Policy

To complete the Psychiatric Evaluation Intake Form you will need the following:

• Your primary care physician's office address, phone and fax number 
• Your local pharmacy address and phone number
• Contact information of your previous psychiatrist/psychotherapist (if applicable and readily available) 
• List of all current medications with dosages and how long you've been taking it. In case we have to prescribe you medications, it is important for us to know all the prescribed medications and supplements you take in order to avoid drug-interactions and make the best medication decisions for you.
• List of all prior psychiatric medications, what dose were you taking and the reason you stopped taking that medication. Take some time to gather your thoughts about previous treatment, medications and what was helpful as this will greatly assist us in formulating the best treatment plan for you.

Prior to the initial appointment, you may contact your primary care physician and have them send a copy of your last physical examination and lab work from the past year to my office. In order for your PCP to send us this information a Request to Release Information is necessary. 

• Print Name, sign and date (required item) for consent to treatment section (top portion)
• Provide your email address and consent for email communication via your signature 
• Permission for release of information is pertinent as without your written consent, I am unable to communicate with anyone regarding your care. You can rescind this permission at any time. Dr. Jain encourages and facilitates active although empathic participation of family/loved ones as extensive research has indicated that people have better prognosis when they are supported by loved ones. Even with a written permission, it is Dr. Jain’s policy that she discuss and collaborate any contact with people involved in your care. 
• Request for release of medical information allows Dr. Jain to get pertinent health records from providers and hospitals that might assist in a more thorough assessment as well as help Dr. Jain provide you with informed, accurate treatment.